Working with Older People, vol. 3, no. 1, 1999, p. 23-25.
The term direct payments covers the provision of money to enable individuals to buy in services they feel they need from whatever source they prefer. Following a nine month review, the government has announced that direct payments will be extended to people aged 65 and over. Article explains the policy background, the origins of the idea, how direct payments work and the problems of the present legislation.
P. Healy and K. McIntosh
Health Service Journal, vol. 109, March 4th 1999, p. 2-3.
Reports that the government has made clear that there will be no early implementation of the recommendations of the Royal Commission on Long-Term Care. The government's main concern about implementing the recommendation is the cost, which is estimated at between £800 million and £1.2 billion per year at 1995 prices.
(See also Financial Times, March 2nd 1999, p. 1; Independent, March 2nd 1999, p. 1; Daily Telegraph, March 2nd 1999, p. 1 + 4; The Times, March 2nd 1999, p. 1)
Community Care, no. 1258, 1999, p. 10.
Reports controversy over the proposed national standards for the residential and nursing care of older people developed by the Centre for Policy on Ageing. The main bone of contention is the proposed minimum room size of 10 square metres. The private sector claims that the costs of implementing such a standard would be prohibitive, and would drive many independent homes out of business.
(See also Community Care, 1999, p. 4-5)
Community Care, no. 1262, 1999, p. 18-19.
Argues that the prospect of garnering the votes of middle-class families with dependent elderly relatives, who face losing most of their inheritance under the present system, may encourage the government to implement the recommendations of the Royal Commission on Long-Term Care.
Daily Telegraph, Feb 23rd 1999, p. 12.
Reports a High Court ruling on Dec. 11th 1998 by Mr Justice Hidden that general nursing care of the elderly was health care and the sole responsibility of the NHS. On the basis of this ruling a Devon farmer is refusing to pay for his mother-in-law's long-term nursing care.
Financial Times, Feb. 18th 1999, p. 1.
Reports leaks of the recommendations of the Royal Commission on Long Term Care. The Commission is proposing to make nursing and personal care for the elderly free outside hospital, which would eventually add more than £5 bn a year to public spending in real terms. The scale of the increased spending being recommended means that government merely put the report out for consultation with no commitment to its findings. This means that changes to the current system of care for the elderly may now not take place this Parliament.
Community Care, no. 1260, 1999, p. 8-9.
The government is promising a new £140 million grant to help carers take a break, but this amounts to an estimated £0.15 per week real benefit to each carer. No extra funding is indicated for the proposed carers' centres. New legal powers conferred on local authorities to address carers' needs opens up the possibility of charging them for services currently free, or charged to the cared-for person. Against a background of rising levels of charges for day centres, home and respite care, and transport for elderly and disabled people, the prospects for carers look less than rosy.
Age Concern England
Working with Older People, vol. 3, no. 1, 1999, p. 25-27.
Age Concern's response to the governments review of direct payments calls for consideration to be given to the use of direct payments to employ relatives, more information and training, and national guidelines on charges for services.
Caring Times, Feb. 1999, p. 20.
Research by GVA Grimley healthcare consultancy predicts an increase in the number of business failures among residential care homes following the introduction of the minimum wage in April 1999.
Caring Times, Feb. 1999, p. 12-13.
Results of a survey on the impact of proposed national required standards in relation to room sizes in care homes predict closures, job losses, bed losses and deaths.
Working with Older People, vol. 3, no. 1, 1999, p. 10-13.
For the second year the government announced extra funding to enable agencies to cope with winter pressures. In return for this funding health and social agencies are expected to co-operate and co-ordinate their efforts and to achieve targets for prevention and the reduction of emergency hospital admissions. Waiting list targets and associated increases in elective activity are to be achieved as well as appropriate local arrangements being put in place to cope with emergency pressures.
Royal Commission on Long-Term Care
London: TSO, 1999 (Cm 4192)
Urgent recommendations include establishing a national care commission to set standards and control budgets, disregarding the value of an elderly person's home for the first three months in residential care, and changing the cut-off point for receiving state help from £16,000 in assets to £60,000. Long-term recommendations include taking Department of Health proposals on pooled health and social services budgets further, joint assessment of care needs by health and social services to provide a single entry point, and making personal and nursing care free at the point of use while charging for living and housing costs.
(For comment and summary see Community Care, no. 1262, 1999, p. 1-3)
British Journal of Social Work, vol. 28, 1998, p. 863-878.
Paper examines the nature of social workers' practice with older people following the implementation of community care legislation, and concludes that the impact on the social work profession has been to locate an increasing control of practice with social work managers.
Journal of Social Work Practice, vol 12, 1998, p. 209-216.
Presents a case study of an NHS continuing care hospital for older people which was transferred to private ownership. Subsequent cuts in this service range from very poor employment conditions now offered by the company to new staff to attempts to make savings in food and incontinence pads.